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Stages of Vaginal Cancer
If you are diagnosed with vaginal cancer, your cancer care team will try to figure out if it has spread, and if so, how far. This process is called staging.
The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer’s stage when talking about survival statistics.
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How are vaginal cancers staged?
The 2 systems used for staging vaginal cancer, the FIGO (International Federation of Gynecology and Obstetrics) system and the American Joint Committee on Cancer (AJCC) TNM staging system, are basically the same.
They both stage the cancer based on 3 factors:
- T (tumor) describes the size of the main tumor and any spread to nearby structures, such as the pelvic wall.
- N (nodes) describes the extent of spread to nearby (regional) lymph nodes.
- M (metastasis) indicates whether the cancer has spread to distant parts of the body outside the abdomen or pelvis.
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced.
Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage. For more on this, see Cancer Staging.
Vaginal cancer stages
Vaginal cancer stages range from stage I through IV and are sometimes divided further using letters. The lower the number, or earlier the letter, the less the cancer has spread. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated similarly.
This system is not used to stage vaginal melanoma, which is staged like melanoma of the skin. Information about melanoma staging can be found in Melanoma Skin Cancer.
Vaginal cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.
Stage grouping: T1a, N0, M0
FIGO stage: I
The cancer is only in the vagina and is no larger than 2 cm (T1a). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
Stage grouping: T1b, N0, M0
FIGO stage: I
The cancer is only in the vagina and is larger than 2 cm (T1b). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
Stage grouping: T2a, N0, M0
FIGO stage: II
The cancer has grown through the vaginal wall, but not as far as the pelvic wall, and is no larger than 2 cm (T2a). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
Stage grouping: T2b, N0, M0
FIGO stage: II
The cancer has grown through the vaginal wall, but not as far as the pelvic wall, and is larger than 2 cm (T2b). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
Stage grouping: T1 to T3, N1, M0 OR T3, N0, M0
FIGO stage: III
The cancer can be any size and might have grown into the pelvic wall and/or has blocked the flow of urine (hydronephrosis), which is causing the kidneys to not work (T1 to T3). It has also spread to nearby lymph nodes in the pelvis or groin (inguinal) area (N1) but not to distant sites (M0).
OR
The cancer is growing into the pelvic wall and/or has blocked the flow of urine (hydronephrosis), which is causing the kidneys to not work (T3). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
Stage grouping: T4, any N, M0
FIGO stage: IVA
The cancer is growing into the bladder or rectum or is growing out of the pelvis (T4). It might or might not have spread to lymph nodes in the pelvis or groin (inguinal) area (any N). It has not spread to distant sites (M0).
Stage grouping: Any T, any N, M1
FIGO stage: IVB
The cancer has spread to distant organs such as the lungs, liver, or bones (M1). It can be any size and might or might not have grown into nearby structures or organs (any T). It might or might not have spread to nearby lymph nodes (any N).
Note: 2 cm is slightly smaller than 1 inch
The following additional categories are not listed in the table above:
- TX: Main tumor cannot be assessed due to lack of information.
- T0: No evidence of a primary tumor.
- NX: Regional lymph nodes cannot be assessed due to lack of information.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Adams TS, Maluleke JC, Cuello MA. Cancer of the vagina: 2025 update. Int J Gynaecol Obstet. 2025;171 Suppl 1(Suppl 1):48-59.
American Joint Committee on Cancer. Vagina. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017:641-647.
Karam A, Berek JS, Kidd EA. Vaginal Cancer. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/vaginal-cancer on September 8, 2026.
Last Revised: October 23, 2026
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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